History: This 23 year-old man was referred by
his optician because of bilateral optic disc swelling. His vision was 6/9 in both eyes and the patient
complained of being unwell for the past 3 monthsand suffered with intermittent blurred vision.
His blood pressure measured 220/130. He was referredto the neurologist on-duty. An urgent CT scan
shows no evidence of space-occupying lesion. His routine blood test showed normochromic normocytic
anaemia and raised urea and creatinineconsistent with chronic renal failure. Renal
scans revealed shrunken kidneys probably secondaryto damage from recurrent ureteric reflux. The
blood pressure was controlled with medication andhe received haemodialysis. The optic disc swelling
resolved when he was seen again at two-month ocular review.